NPIMap

Individual provider Active NPI

Petra Kriz, MD

  • Anesthesiology Physician
  • Portland, OR
National Provider Identifier
1568568087
Registry record updated Nov 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD26517 Issued in OR
Practice address
120 NW 14TH Ave
Ste 300
Portland, OR 97209-2643
Phone
(503) 299-9906
Fax
(503) 225-9002
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 35083476 OH
Anesthesiology Physician 207L00000X 017195 ME
Anesthesiology Physician 207L00000X MD26517 OR Primary

Addresses

Primary practice location

120 NW 14TH Ave
Ste 300
Portland, OR 97209-2643

Mailing address

PO Box 2040
Portland, OR 97208-2040
Phone (503) 299-9906

Other identifiers 3

IdentifierTypeStateIssuer
274549MedicaidOR
8486631MedicaidWA
2500449MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081119000830 MA Practitioner - Anesthesiology 9133017973 Reassigns benefits to 1 organization
I20230516000368 CT Practitioner - Anesthesiology 9133017973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodland Anesthesia Associates PCGroup PAC ID 8820083652, 172 clinicians

Practice addresses (Care Compare)

114 Woodland St
Hartford, CT 06105-1208
Phone (860) 714-6654

271 Carew St
Springfield, MA 01104-2377
Phone (860) 714-9688

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
017195MEMDAnesthesiology Physician
35083476OHMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinic Physician Services Co. LLC Anesthesiology Past Accepting new patients
Oag Trauma Services LLC Anesthesiology Past Accepting new patients
Oregon Anesthesiology Group PC Anesthesiology PastSince Jul 25, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: pkriz2384831@direct.trinity-health.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1568568087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2040",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972082040",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 NW 14TH AVE",
            "address_2": "STE 300",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972092643",
            "telephone_number": "503-299-9906",
            "fax_number": "503-225-9002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIZ",
        "first_name": "PETRA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OH",
            "license": "35083476",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "ME",
            "license": "017195",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OR",
            "license": "MD26517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274549",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8486631",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2500449",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.